Lipo 360

 Frequently Asked Questions

How can I know if Power Assisted Lipo (PALs) / Lipo is right for me?

My job is to tell you what surgery can do for you and to help you understand the risks. Only you can decide whether the operation is right for you. I think it will help you achieve your aim. Although I cannot give you a guarantee, I believe you will like the result. The decision remains a personal one and you must make it.

Can I get the same results without Power Assisted Lipo (PALs) / Lipo?

I only do Power Assisted Lipo (PALs) / Lipo when no other good alternatives exist. Your need falls into this category. Without surgery, I cannot correct your problem as successfully. When I examine you in the office, I assess the possibility of other treatments. I balance the advantages and disadvantages of surgery in your case. If I recommend surgery then I think the advantages outweigh the disadvantages. If you have concerns or you are not clear about the operation, call me before the operation. Make certain your mind is clear long before the day of surgery. I want you to go into the operation with a clear and confident attitude.

How much will the operation cost?

My consultant will give you an estimate of the cost of your surgery. If you cancel surgery without adequate notice, we will charge a cancellation fee.

Will my insurance pay for Power Assisted Lipo (PALs) / Lipo?

Probably not. Insurance companies only pay for surgery if it is not considered cosmetic surgery. My office can give your insurance company documentation about your condition, such as the operative note. My office will neither complete insurance forms nor communicate with insurance companies. You must take full responsibility for any dealings with your insurance company.

Am I being vain to have this operation?

Most people at some time before surgery have fears and doubts. A common concern is that they are being vain. My experience has been that most patients who have cosmetic surgery are no vainer than anyone else. What does distinguish them is a desire to get the most out of life. Looking after our appearance is not a fault. After all, would you leave your house with broken gutters or peeling paint? Why do less for your body? I think you should feel proud of yourself for having the courage to want to change something which you find unacceptable. I do emphasize that you should only have the surgery if it is for you. It is a big mistake to have surgery for somebody else.

What do I do to get ready for Power Assisted Lipo (PALs) / Lipo?

Begin by thinking about what you will need in the house in the days after surgery. Do your shopping ahead of time and relax for a few days after surgery. Make certain you have filled all your prescriptions and know how to take them. For a few days before surgery you may want to take Arnica, as this can reduce bruising and encourage healing. Make certain you do not take any aspirin or aspirin containing medicine for 10 days before surgery. This can increase your risk of bleeding. Antihistamines, Advil and vitamin E may also increase bleeding so you should avoid them. There are many herbal remedies that may interfere with healing. Take a look at the list we have provided for you and stop any herbal remedies two weeks before surgery. The night before surgery, set an alarm so you know you will not oversleep. This is especially important if you take a sleeping tablet the night before surgery. Most importantly, call if you have any questions. The best time to ask questions is a few days before surgery. The worst time is right before your operation when you may be sleepy and confused.

Do I take my regular medicines before Power Assisted Lipo (PALs) / Lipo?

Let me know what medicines you take so I can advise you. Yes and No. I recommend that you take your regular medicines, such as those to control blood pressure, at your usual time. If you use a small sip of water to swallow the pill there is usually no problem. Some medications not to miss around the time of surgery include those for blood pressure, heart disease, psychiatric problems and birth control pills. If you take blood thinners, such as Coumadin or Aspirin, you must stop taking them 10 days before surgery. You should discuss this with the doctor who prescribes them for you.

Are there any medicines I should not take before Power Assisted Lipo (PALs) / Lipo

Yes. Do not take aspirin for 10 days before surgery. It may increase the risk of bleeding. Remember, many over the counter medicines contain aspirin. So, check the label carefully. Other medicines that may increase your risk of bleeding include vitamin E, Advil and antihistamines. Many cold remedies contain antihistamines. My office will provide you with a list of herbal remedies that can interfere with surgery. You should read this list carefully.

Do I need any special tests?

If you are in good health, you may need only Complete blood count (CBC), Chemistry panel (Chem 12), and coagulation studies (PT and PTT).I may order tests or suggest you see your treating physician. If needed it, a prescription for these tests will be given to you to take to the lab or your treating physician.

Is there anything I can do to reduce scarring or bruising?

For the first day or two after surgery I recommend that you rest a lot. All surgery is tiring. You can reduce swelling by elevating the site of surgery. I do not know any consistent way to reduce scarring. Some patients feel that applying vitamin E or Aloe Vera may help. If you apply these creams do not rub the scar for about six weeks because you can damage the fragile new tissue. If you have tapes or stitches in place, do not use any cream or lotion unless instructed. Scar reducing gels and creams such as Stratamed can help with wound healing. This can be purchased on Amazon.

Is there anything I need to tell my surgeon before Power Assisted Lipo (PALs) / Lipo?

The most important thing I need to know before surgery is what you want to achieve. Make certain that you tell me what it is you do not like and what you want corrected. Never hesitate to ask questions. Make certain I answer your questions before the day of surgery. Just before surgery is not a good time to ask questions. You may be sleepy and it is unlikely you will remember the answers. The plan for surgery needs to be clear before you come to the operating room. I need to know about your general health and medical history. When you first come to my office, we ask you questions about your medical history. Please tell me of any changes. I need to know if you have any allergies, especially to antibiotics and pain killers. It is important that you tell me about all medicines you take regularly, especially heart medicines, blood thinners, insulin, hormones, antidepressants or psychiatric medicines and birth control pills. If you have had surgery, I need to know when and what operations you had. It helps me to know if things went well or if you had complications, such as bleeding or anesthetic problems. Finally, tell me about any previous treatment for the problem we are treating now.

What do I eat before Power Assisted Lipo (PALs) / Lipo?

It is a good idea to eat a nourishing diet for a week or two before surgery and consider increasing your vitamin C intake. Do not go on a strict diet in the weeks before your operation.

How early do I need to be at the practice?

I recommend that you are at the operating suite half an hour before surgery. Although this seems early, it is necessary to get the best result for you. Often I prescribe medicines before surgery that make you feel comfortable during surgery. If you do not have these medicines on time, they are not as effective. If you need special tests, it often takes an hour for results to return. If you do not arrive at the recommended time, for your own safety, I may cancel or postpone your surgery.

Where will the procedure be done?

I will do your operation in our surgical suite. This means you do not have to stay in a hospital. Usually I do surgery in the early morning and you can often be home by early afternoon.

How is the operation done?

The principle of the operation is straightforward. After flooding the area to be suctioned with dilute local anesthetic, the fat then removed through multiple small incisions. The fat is removed in individual suctioned "tubes". If your skin is lose, then laser smart lipo will be performed at the end of the surgery.

Where is the scar going to be?

The scars for Power Assisted Lipo (PALs) / Lipo are multiple and small. They are often placed in the crease lines, as inconspicuously as possible. All surgery requires a scar and all scars take time to soften and fade. You will not see the final appearance of your scar for a year after surgery. It is usually red and raised sometimes discolored for the first month or two after your operation.

How long does Power Assisted Lipo (PALs) / Lipo take?

This depends on the number of areas treated but is often about two to four hours. You should allow 30 minutes to one hour for recovery in our facility.

When will I be able to go home after Power Assisted Lipo (PALs) / Lipo?

After I finish your operation you will go home as you long as your vitals and your clinical condition are stable and your ride is ready to pick you up. If you are planning to drive yourself back home, then when the nurses feel you are alert you can go home. rarely, patients are slow to recover or have complications. If this happens, you may need admission to a hospital overnight.

Can I drive myself home after Power Assisted Lipo (PALs) / Lipo?

No. After surgery you will be under the influence of medications. It is dangerous to drive. If you do not have anyone to drive you home we can call a taxi. Tell the nurses in the surgery unit. If you use a taxi you may need to stay in the recovery room longer.

What anesthetic is used for the operation?

This operation is performed under local anesthetic. Although small, there is a risk to all anesthetics.

What are the complications?

After all operations there is bruising and swelling. This lasts about two weeks but can continue for a month or more. Remember that the human body is asymmetrical and that even after surgery both sides of the body will look different. All surgery requires an incision and will leave a scar. In most patients the scar heals well, but in a small number of people the scar remains thick and heavy. At the time of surgery the small nerves that supply feeling to the skin are damaged. This may cause changes in sensation including numbness and pain. Although uncommon, bleeding and infection are risks and can be serious. You will have pain and discomfort after this surgery. Usually the pain only lasts for a few days to weeks, and rarely can be permanent. About one percent of all operations lead to major complications. You must weigh the pros and cons; it is for you to decide. This is a surgical procedure and as such potentially serious complications such as a blood clot or embolus or an unexpected response to drugs or anesthetics can occur. Beside the complications that can develop after any surgery, there are problems that are special for your surgery. These include surface irregularity and the need for additional surgery. Make certain you understand all consent forms.

Will I need to take any special medicines?

In most cases I prescribe an antibiotic. If I prescribe an antibiotic it is important that you take it. The other medicines you can take at your discretion. If you think you may be allergic to any of the medicines, stop taking them and call my office immediately. Remember that all medicines have side effects. One of the most common is gastrointestinal upset. This means you can have an upset stomach or diarrhea. If this becomes severe call my office. Many patients are surprised that they can obtain good pain relief with simple over the counter medicines like Tylenol. Do not take aspirin for a few days after surgery because this can increase the risks of bleeding.

How do I look after myself after Power Assisted Lipo (PALs) / Lipo?

You can follow some simple rules to make your surgical experience more pleasant. First acknowledge that you have had surgery and it takes time to heal. Be patient. For the first twenty-four hours take it easy, but be active . This is a good time to read all those books, or watch the videos, that you have been promising yourself you would read or watch over the last few months. After the first day or two you will start to feel more comfortable but you are still not ready to begin vigorous activity. If needed, I will give you specific instructions. Take plenty of fluids and eat a balanced nourishing diet. I suggest additional vitamin C for about six weeks. Do not take extra vitamin E at this point because it can increase bleeding. You should not drive yourself for about 2 days after surgery. It is important that if you have any questions you call the office.

Do I need somebody with me after Power Assisted Lipo (PALs) / Lipo?

Most patients feel more comfortable if they have somebody with them for the first twenty-four hours after surgery.

Will I be in pain after Power Assisted Lipo (PALs) / Lipo?

All surgery is associated with pain and discomfort. Remember you can often get sufficient pain relief with simple over the counter medicines like Tylenol. I always ask you if you need a prescription pain killer for after surgery pain to let me know, so we can write you a prescription ahead of time and before I perform surgery so you can have it available after surgery. Do not take aspirin because this can increase the risk of bleeding. By the end of the first week the pain is usually much less.

What will I look like after Power Assisted Lipo (PALs) / Lipo?

All surgery is associated with bruising and swelling, so you should expect this for one to two weeks after your operation. Some patients remain bruised, swollen, and few areas on under skin lumpiness that need vigorous massage might persist for longer than few weeks, and in rare cases a month or more. You may start to see the results quickly but you will not see the final benefits of your surgery for many months. I do not consider you fully healed for at least six months.

Will I like the results?

Your satisfaction with the results is very important to me. Most patients are happy with the outcome and serious complications are unusual. You are more likely to be happy if you have realistic expectations of what this surgery can do for you.

What happens if I do not like the results?

No surgeon can give a guarantee about the outcome but I can say that I will work with you to achieve the result you want. If this means additional surgery, I will usually do this for you at an additional surgical fee that will discuss at that time, if I think it is medically safe and likely to be effective. You would be responsible for any charges for an operating room, anesthesia or supplies.

How long does it take to heal?

Healing is a slow process and varies dramatically from person to person, and side to side. It takes six weeks for any scar to begin to soften and at least a year to be complete. I do not consider you healed until about a year after your surgery.

When can I return to work?

This depends on your job. After any operation it is necessary to take it easy for a day or two. During the first week you will begin to feel more like yourself and may be able to perform light duties such as using a telephone or computer. You should not do any heavy lifting for at least a month.

When can I exercise?

I encourage you to begin gentle short walks by the next day after surgery. A serious complication of any surgery is the development of blood clots in the legs as a result of inactivity. The risk of this is reduced by early movement. After two weeks you can begin more vigorous activity but you should not do any heavy lifting or vigorous jogging for at least 3 weeks. Sometimes there are exceptions to these rules. So if you have any special needs please ask me.

Do I have to eat a special diet?

No. I recommend that you eat a balanced diet and drink plenty of fluids. I like my patients to have additional vitamin C for about six weeks after surgery. Do not take extra vitamin E right after surgery because it can increase bleeding. After two weeks additional vitamin E by mouth may reduce the risks of thickening of the scar.

Afterwards do I need to wear any special clothing or garment?

Possibly If you need to wear a special garment I will either put it on at surgery or give you instructions about getting one.

Will I need to change any bandages?

At surgery I will apply a tight elastic tape or garment. This reduces the risk of bleeding and holds the skin in good position. Do not remove this garment except when changing the absorbing pads bandage for 48 hours after surgery. After two weeks you can use a roll-on garment.

Will my incision wound drain after Power Assisted Lipo (PALs) / Lipo?

I do not stitch the small incision we use during the surgery to allow the anesthetic fluid and the residual blood to drain; this minimizes swelling, bruising, collection of fluids under the skin (seroma). Expect to change the absorbent padding a few times during the first 48 hours.

How do I look after my incisions?

You do not need to do anything special with your incisions. If I need you to clean the area I will tell you.

When can I bathe or shower?

You can bathe forty-eight hours after surgery, but do not massage the area of the incision. Re-apply the garment after you bathe

Do I have to sleep in any special position?

You may sleep in any comfortable position. Try to avoid pressure on the area of surgery and follow any special instructions you may have been given after surgery.

Do I need to use ice on the surgical site?


When can I have sex?

You can resume sexual activity as soon as you feel comfortable. For two weeks avoid pressure at the site of surgery and do not massage the area.

Should I stop smoking around the time of Power Assisted Lipo (PALs) / Lipo?

Yes. Smoking delays healing and can cause your skin to die leaving bad scars. I like my patients to stop smoking for two weeks before and after their operation.

May I drink alcohol around the time of Power Assisted Lipo (PALs) / Lipo?

Narcotics and sleeping tablets will interact with alcohol so do not drink at the same time as you take them. They will also make you drowsy so do not drive while you are taking them. After the first few days when you are not taking painkillers you may drink a small amount of alcohol.

How will I feel emotionally after Power Assisted Lipo (PALs) / Lipo?

Many people feel emotional after surgery. Some even become depressed. If this happens to you do not feel you are alone or frightened. It will almost certainly pass. Talk to me about it. If it becomes persistent or serious I can help you find a counselor.

How long will the results of Power Assisted Lipo (PALs) / Lipo last?

This depends a great deal on the individual patient and the type of skin. Unless you gain weight the results are long lasting.

Can I have the operation again?

Almost all surgery can be repeated. For most patients this is not needed. As time passes you may find that you need to modify or update something, which was done several years ago. This is usually not a problem.

Do I tell people I have had cosmetic surgery?

Cosmetic surgery is a very personal matter. Only you can decide who should and should not know you have had surgery. I recommend that you talk about surgery with at least one other person you know well. Your spouse or a good friend are obvious examples. You could also discuss surgery with a therapist or your family doctor. Unfortunately, even today many professional people are not well informed about cosmetic surgery. If you let those close to you know about the operation then you can ask for help afterwards without being embarrassed or shy.

How do I reach Dr. Ramirez if I have an emergency?

Serious emergencies are rare after this surgery. If your emergency is life threatening, go to the nearest emergency room or dial 911. They will begin treatment and contact me for you. The quickest way to reach the doctor is by calling 210-413-4313 The office is open between 8-5 pm. During these hours call 512-617-9200. Dr. Ramirez is not in the office on Mondays.

When can I drive a car?

You can drive a car at about 2 days after surgery. Remember that narcotics may make you drowsy. Do not drive and take narcotics.

Are patients happy after Power Assisted Lipo (PALs) / Lipo?

Most patients who have Power Assisted Lipo (PALs) / Lipo are happy with the result. Even though they may develop complications such as irregularity, most say they would do the operation again.